Three surprising tips for a healthy pregnancy

The do’s and don’ts of pregnancy can be overwhelming at best. For an expectant parent who is using substances, the rhetoric is clear: just don’t.

But in hearing from parents themselves (during a study entitled Treatment and Prevention of Illicit Substance Use among Pregnant and Early Parenting Women), it is clear that there is a lot more to having a healthy pregnancy than abstaining from the likes of cigarettes, alcohol, opiates, etc.

Looking more closely, many parents who struggle to do the best they can for themselves and their growing families are caught in an awful web of intense and complex socioeconomic challenges, and their perspectives offer a much more nuanced understanding of health and the myriad of factors that impact our well-being.

So here are three fundamental tips for a healthy pregnancy, gleaned from the parents’ stories and lots of reading, which perhaps underlie all other choices for better health.

Tip 1: Break the cycle of poverty

Money may not buy love, but in many ways it can buy health. The numbers show that your chances of falling ill and dying sooner goes up as income goes down. Anyone who has struggled to buy fresh food, running shoes or medicine will know the link between money and health first hand. Parents in our study often saw substance use as a problem when it interfered with the ability to buy healthy food or pay rent – but rarely challenged the socioeconomic factors beyond their control.

The fact is, where you live may decide how soon you die. For example there is 10 year difference in life expectancy between Hope (75.5) and Richmond (85.6). It’s all about avoiding microcosms where opportunities, services and supports are lacking – where whole communities (socially or geographically defined) have slid between the cracks.

For struggling parents, who are often themselves born into disadvantage, the need for wraparound services that help with housing and comprehensive health and social supports is clear. Thankfully in Victoria, HerWay Home is able to meet some of this need, though safe and affordable housing in Victoria remains elusive.

And let’s not forget that one in five children in BC live in poverty (and half of single parents are poor) – with or without having substances in the house. Poor children suffer health consequences that may alter their entire lives. Cripplingly low income assistance payments, low-income thresholds for social service eligibility, and the high costs of housing and daycare are squeezing families in a big way.

Many of the potential harms of parental substance use on young and unborn child are virtually indistinguishable from the harms of poverty. Let it be known that the last word on the ‘crack baby’ epidemic was that poverty hurts kids more than being born to mothers with cocaine addiction.

Health and income inequity are big problems in BC, and any moral charge against mothers who use substances may be better spent advocating to give poor families a fighting chance.

Tip 2: Support healing from trauma

Trauma interferes with recovery from addiction. This is true for many new and expectant mothers, and dovetails with environmental, social and structural factors that make it harder to break the larger cycle of poverty and marginalization.

I’d love to advise avoiding trauma in the first place, but for half of Canadian women and one-third of Canadian men, it’s probably too late. Childhood trauma in particular strongly predicts:

  • Drug, tobacco and alcohol addiction
  • Depression, post-traumatic stress disorder (PTSD), and suicide attempts
  • Having >50 sexual partners, sexually transmitted infections (STIs), and teen pregnancies
  • Physical inactivity and severe obesity (ACE Study).

While pregnancy and becoming a parent can and do bring a lot of opportunities for joy and healing, it’s no panacea. Kate (a mom in our study, pseudonym) said:

“Just because you’re pregnant it doesn’t magically change what’s going on for you and how you’ve been brought up and all the shit that’s happened to you.

But seeking help is easier said than done. Our health and social services systems are only starting to become “trauma-informed” – which means service providers often overlook trauma as the root of the problem, or even re-traumatize patients with their insensitivity.

Tip 3: Community love bomb

The people around you (and the co-parent you choose) play huge roles in making or breaking your health habits. On the flip side, judgment, stigma and social exclusion can keep a new mom down.

For many parents in our study, keeping sober meant cutting ties with family and friends who were themselves mired in risky lifestyles. In the wake of these deep personal loses, mothers especially were coldly judged for using any substances at all.

Mothers who are struggling to make healthy choices for themselves and their families need to be given more credit for their love and commitment to their kids, and more appreciation for the immensity of the obstacles they face (often with roots in childhood trauma, and other circumstances beyond their control).

Fathers are only sometimes given credit for the role they play, and need to be more consistently acknowledged, encouraged and supported when this role can be a positive one.

Strong communities are built on trust and respect – nurturing these in our services will help support parents exactly where they are, and position us to reduce many complex barriers to health and well-being.

A photo of Samantha Magnus

Author: Samantha Magnus, Research Affiliate, Centre for Addictions Research of BC.

**Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC.

Risk of Injury: The Implications of Mental Health, Alcohol and Gender

Each year, hundreds of thousands of deaths occur due to intentional and unintentional injuries related to alcohol use. Alcohol impairs coordination as well as our ability to perceive and respond to hazardous situations, making it more likely that we will get hurt. Research shows the risk for injury increases as the amount of alcohol use increases. For example, someone consuming five or more drinks on one occasion is 10 times more likely to get injured in the following six hours. But are certain people more likely to get injured when they drink? Are there additional factors associated with alcohol use that could further increase your risk of injury?

In my Master’s thesis, I looked at how alcohol use, mental health symptoms and gender contributed to the risk of injury for British Columbians. I used data from the Alcohol and Other Drugs Monitoring Study, which collects data from people who are admitted to the Emergency department at the Royal Jubilee Hospital in Victoria and Vancouver General Hospital.

I found that the risk for injury increased as the amount of alcohol use increased. The greatest risk of injury is for men, and those consuming six or more drinks in the six-hour period prior to the injury event. I also found that mental health symptoms such as anxiety or depression exacerbated the effect of alcohol and the likelihood of injury among women. Women who consumed alcohol and had mental health symptoms were almost twice as likely to be injured compared to women without mental health symptoms.

Why would the presence of mental health symptoms place women at a greater risk for experiencing injury from alcohol use? It could be that women experiencing mental health issues are more likely to drink as a form of self-medication; however, it is difficult to determine the direction of this effect, as long-term alcohol use has been known to lead to the development of depression and anxiety. Another possible explanation is that because women with mental health symptoms are more likely to take medication to treat the symptoms, the alcohol may be interacting with the medication and resulting in detrimental effects. Finally, higher levels of impulsivity are found among individuals experiencing depression, and it may be that the combination of impulsivity and alcohol use could result in someone engaging in more risk-taking behaviors, thereby placing them at a greater risk of injury.

How can we use this information to help prevent future injuries? It is important that health care providers are aware of the combined effect of mental health symptoms and alcohol on risk of injury. If individuals presenting injuries at the emergency departments could be quickly screened for mental health symptoms such as anxiety and depression, the treatment of these symptoms could potentially result in a reduction of risky alcohol use and help to prevent future injuries. For future research, we hope to continue to look at the inter-relationships between these three factors on risk of injury. In particular, we want to look at whether the risk may differ when comparing violent to non-violent related injuries.

audra roemer

Author: Audra Roemer, Centre for Addictions Research of BC

Audra Roemer completed her Masters Degree in Clinical Psychology at the University of Victoria in July 2014 and will be starting her PhD in September 2014. She studied at the University of British Columbia for her Bachelors degree; her research interests include: substance use, family and individual risk factors, gender, prevention, violence and injury, and child and adolescent development.

**Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC.